Related Experiment Video
Updated: Jul 11, 2026
12:22
A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation
Published on: April 2, 2012
18.0K
Misleading Detection of Herpes Simplex Virus Type 1 In A Patient with Paraneoplastic Encephalitis
Mirko Lischer1, Marten Trendelenburg1, Özgür Yaldizli2
1Division of Internal Medicine, University Hospital of Basel, Basel, Switzerland.
European Journal of Case Reports in Internal Medicine
|September 10, 2025
Summary
Autoimmune encephalitis, particularly paraneoplastic encephalitis linked to anti-Hu antibodies, can mimic infectious causes like herpes simplex virus type 1 (HSV-1). Early detection of onconeural antibodies is crucial for diagnosing underlying cancer and guiding treatment.
Area of Science:
- Neurology
- Immunology
- Oncology
Background:
- Encephalitis presents diagnostic challenges due to diverse infectious and autoimmune causes.
- Autoimmune encephalitis, including paraneoplastic variants with onconeural antibodies like anti-Hu, is often associated with malignancies.
- Herpes simplex virus type 1 (HSV-1) is a common infectious cause, complicating differential diagnosis.
Purpose of the Study:
- To highlight the diagnostic complexities in differentiating infectious and autoimmune encephalitis.
- To emphasize the importance of testing for onconeural antibodies in suspected autoimmune encephalitis.
- To underscore the clinical significance of early paraneoplastic encephalitis recognition.
Main Methods:
- Case report of an 88-year-old woman with encephalitis.
- Analysis of cerebrospinal fluid (CSF) for infectious agents and antibodies.
- Brain imaging (MRI) and positron emission tomography-computed tomography (PET-CT) for lesion detection.
- Biopsy for histopathological confirmation of malignancy.
Main Results:
- Initial presentation suggested infectious encephalitis, with later CSF revealing HSV-1 and MRI showing hippocampal hyperintensities.
- Retrospective analysis of initial CSF identified high-titer anti-Hu antibodies.
- PET-CT and biopsy confirmed small cell lung cancer.
- Treatment for both HSV-1 and cancer provided transient improvement, followed by neurological decline.
Conclusions:
- Onconeural antibodies, like anti-Hu, are an under-recognized cause of encephalitis and warrant specific testing.
- Anti-Hu antibody detection necessitates a thorough malignancy workup.
- Positive HSV-1 PCR in CSF requires clinical correlation and does not confirm active infection alone.
More Related Videos
13:22Detection of the Genome and Transcripts of a Persistent DNA Virus in Neuronal Tissues by Fluorescent In situ Hybridization Combined with Immunostaining
Published on: January 23, 2014
18.7K
08:20Hippocampal Neuronal Cultures to Detect and Study New Pathogenic Antibodies Involved in Autoimmune Encephalitis
Published on: June 2, 2022
3.8K
Related Concept Videos
01:28Herpes
Herpes simplex type 1 (HSV‑1) is a widespread pathogen responsible for orolabial lesions. It is an enveloped, double-stranded DNA (dsDNA) virus belonging to the family Herpesviridae. Once the virus infects a host cell, its double‑stranded DNA genome is delivered into the nucleus, where a coordinated cascade of immediate‑early, early, and late gene expression directs viral DNA replication, structural protein synthesis, and virion assembly. After primary infection of epithelial cells, HSV-1...
01:20Chickenpox
Chickenpox is an acute, highly contagious disease caused by the varicella-zoster virus (VZV), a double-stranded DNA virus belonging to the Herpesviridae family. Its transmission occurs primarily through the inhalation of respiratory droplets or direct contact with vesicular fluid from skin lesions. The incubation period typically ranges from 10 to 21 days, during which the virus replicates and disseminates through sequential phases within the host. Although generally self-limiting in children,...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:25Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...